Evaluation of Two Diuresis Renography Decision Support Systems to Determine the Need for Furosemide in Patients with Suspected Obstruction  

Oleh:

Taylor, Andrew ; Hill, Andrew N. ; Binongo, Jose N. E. ; Manatunga, Amita K.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: American Journal of Roentgenology vol. 188 no. 05 (May 2007), page 1395-1402 .
Topik: NUCLEAR MEDICINE; Genitourinary tract imaging; kidney; nuclear medicine; radiology practice; renal disease

Ketersediaan

Perpustakaan FK Nomor Panggil: A13.K.2007.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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OBJECTIVE. The purpose of this study was to compare the decisions regarding the need for furosemide made by two independent renal decision support systems, RENEX and CAR-TAN, with the need for furosemide determined in clinical practice and by expert reviewers using the baseline plus furosemide protocol. SUBJECTS AND METHODS. RENEX and CARTAN are independent decision support systems that reach their conclusions without operator input. RENEX is a knowledge-based system and CARTAN is a statistical decision support system. Both were trained using the same pilot group of 31 adult patients (61 kidneys) referred for suspected obstruction. Subsequently, both systems were prospectively applied to 102 patients (200 kidneys) of whom 70 received furosemide; decisions regarding the need for furosemide were compared with the clinical decisions and the decisions of three experts who independently scored each kidney on the need for furosemide. Differences were resolved by consensus. RESULTS. RENEX agreed with the clinical and experts' decisions to give furosemide in 97% (68/70) and 98% (65/66) of patients, respectively, whereas CARTAN agreed in 90% (63/70) and 89% (59/66), respectively, p < 0.03. In contrast, CARTAN agreed with the experts' decision to withhold furosemide in 78% of kidneys (87/111), whereas RENEX agreed in only 69% of kidneys (77/111), p = 0.008. CONCLUSION. Use of RENEX or CARTAN as decision support tools in the baseline plus furosemide protocol has the potential to help the radiologist avoid unnecessary imaging and reduce the technologist, computer, camera, and physician time required to perform the procedure.

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